Endoscopic bypass grafting method utilizing an inguinal approach

Abstract

A method for implanting an end portion of a graft within the body of a patient during a bypass grafting procedure is disclosed. The body has a circulatory system which includes a femoral artery and an aorta. The method includes the steps of (i) making an incision in the body of the patient so as to expose the femoral artery and an inguinal ligament, (ii) advancing an endoscope between the femoral artery and the inguinal ligament until a distal end of the endoscope is positioned at a working site within the body, (iii) advancing the end portion of the graft between the femoral artery and the inguinal ligament to the working site, wherein said end portion advancing step includes the step of advancing the end portion of the graft through the endoscope, and (iv) forming an anastomosis between the end portion of the graft and the aorta at the working site.

1 . A method for implanting a graft conduit in communication with an aorta in the body of a patient, comprising: 
 forming an incision in the body of the patient for accessing the aorta;    inserting the graft conduit through said incision toward a site along the aorta;    installing within the aorta through an opening the graft conduit in collapsed configuration;    expanding the graft conduit to contact walls of the aorta in the region of the site;    anastomosing one end of the graft conduit to the aorta at the site; and    anastomosing another end of the graft conduit outside the aorta to a blood vessel in the body.    
   
   
       2 . The method according to  claim 1  in which the graft conduit is introduced into the aorta from a location below the site for transfer between the location and the site.  
   
   
       3 . The method according to  claim 1  in which the graft conduit in collapsed configuration is expanded and urged into contact with the aorta walls in response to a balloon disposed to expand under fluid pressure supplied thereto.  
   
   
       4 . The method according to  claim 3  in which fluid under pressure is supplied to the balloon along a channel that extends intralumenally within the aorta between the balloon and a downstream location along a vessel in fluid communication with the aorta.  
   
   
       5 . A method for implanting a graft conduit in communication with an aorta in the body of a patient, comprising: 
 forming an incision in the body of the patient below the inguinal ligament to expose the region between the inguinal ligament and the femoral artery for access in a superior direction toward the aorta;    inserting the graft conduit through said incision in a superior direction toward a site along the aorta;    anastomosing one end of the graft conduit to the aorta at the site; and    anastomosing another end of the graft conduit to a blood vessel in the body.    
   
   
       6 . The method according to  claim 5  in which the graft conduit is exposed within said region; and 
 said another end of the graft conduit is anastomosed to the femoral artery below the inguinal ligament.